20240 vs 20245

20240 vs 20245

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Should we bill 20240 superficial or 20245 deep for biopsy . I feel the codes our providers are selecting is incorrect they are picking 20245 (deep)

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Asked on May 18, 2022 5:02 pm
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superficial 20240

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Answered on May 18, 2022 5:08 pm
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More specifically where is your biopsy? Most likely, if you are coding dental, you are going to use 20240 (superficial), but I would hate to say without hearing specifically where this biopsy is taking place.

20240:
The physician performs an open biopsy on bone to confirm a suspected growth, disease, or infection. With the patient under general anesthesia, and placed in the appropriate position, the physician makes an incision overlying the biopsy site and carries it down through the tissue to the level of the bone. A piece of bone tissue is removed and sent for examination. The wound is sutured closed, and the patient is moved to the recovery area.

Report 20240 for a superficial bone biopsy (rib, sternum, spinous or olecranon process, patella, calcaneus, tarsal or metatarsal, carpal or metacarpal, and phalanx).

Report 20245 if the bone biopsied lies deep, such as the femoral or humeral shaft and ischium.
Reference: -Optum Encoder

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Answered on May 18, 2022 7:15 pm
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More specifically where is your biopsy? Most likely, if you are coding dental, you are going to use 20240 (superficial), but I would hate to say without hearing specifically where this biopsy is taking place.

20240:
The physician performs an open biopsy on bone to confirm a suspected growth, disease, or infection. With the patient under general anesthesia, and placed in the appropriate position, the physician makes an incision overlying the biopsy site and carries it down through the tissue to the level of the bone. A piece of bone tissue is removed and sent for examination. The wound is sutured closed, and the patient is moved to the recovery area.

Report 20240 for a superficial bone biopsy (rib, sternum, spinous or olecranon process, patella, calcaneus, tarsal or metatarsal, carpal or metacarpal, and phalanx).

Report 20245 if the bone biopsied lies deep, such as the femoral or humeral shaft and ischium.
Reference: -Optum Encoder

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Answered on May 18, 2022 7:16 pm
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More specifically where is your biopsy? Most likely, if you are coding dental, you are going to use 20240 (superficial), but I would hate to say without hearing specifically where this biopsy is taking place.

20240:
The physician performs an open biopsy on bone to confirm a suspected growth, disease, or infection. With the patient under general anesthesia, and placed in the appropriate position, the physician makes an incision overlying the biopsy site and carries it down through the tissue to the level of the bone. A piece of bone tissue is removed and sent for examination. The wound is sutured closed, and the patient is moved to the recovery area.

Report 20240 for a superficial bone biopsy (rib, sternum, spinous or olecranon process, patella, calcaneus, tarsal or metatarsal, carpal or metacarpal, and phalanx).

Report 20245 if the bone biopsied lies deep, such as the femoral or humeral shaft and ischium.
Reference: -Optum Encoder

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Answered on May 18, 2022 7:18 pm
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